We all build shields to defend ourselves against emotional harm, our so-called defense mechanisms. If they are adaptive, they are psychologically beneficial. If they maladaptive, they undermine our growth.

Take the real-life example of Jenny, a patient whose identity has been altered here to protect her privacy. Jenny has decided that the only way to protect herself from harm is to hide her faults by trying to be perfect. She hardly sleeps more than four hours a night. She is an accountant and works herself ragged. She desperately longs to get off her exercise bike before the two hours she’s on it every night but doesn’t dare to. Children, husband, clients, all vie for her attention. She came into therapy because she felt that she couldn’t keep the pieces of her life together any longer.

Similarly, Gus came to therapy as he approached his 50th birthday because he had once again lost his motivation for work and was afraid he would find himself unemployed. He proved to be extremely sociable and had an energetic optimism that was contagious. His ease with people promised intimacy but never seemed to materialize. People found him elusive. He refused to make plans and mostly lived from moment to moment. His high energy and intelligence generated expectations for superior job performance. However, he would often grow bored at work and his performance lagged. Whereas in the past he changed jobs when he lost interest, this time around he felt he was running out of professional prospects.

In our sessions it was revealed that he had lived in a state of perpetual childhood, or what is known as the Peter Pan syndrome. Where most of us manage to make the transition from childhood to into adulthood, Gus had shunned taking on adult responsibilities. His primary goal seemed to be to minimize pain and maximize pleasure.

It became apparent in therapy that neither Jenny nor Gus considered their behavior as symptoms of adults trying to hide their perceived failings. Upon closer scrutiny it became apparent that they both suffered from attention deficit disorder.

Stimulants are the first-line approach to addressing ADD, and counseling to help an unruly mind from straying. People with high blood pressure or a heart condition need to be closely monitored when taking stimulants. Antidepressants are a second-line treatment.